Last Updated: September 4, 2026
Medi-Cal vs. Covered California: What’s the Difference? 2026 Guide
Medi-Cal and Covered California are often mentioned together, which can make them seem like the same program. They are not.
Medi-Cal is California's Medicaid program for eligible people who meet income and other program requirements. Covered California is California's official health insurance marketplace, where individuals and families can purchase private health insurance and may qualify for financial help.
If you qualify for Medi-Cal, you may receive free or low-cost public health coverage. If you do not qualify for Medi-Cal, you may be able to purchase a private health plan through Covered California, sometimes with financial assistance that lowers your premium and other costs.
Medi-Cal vs. Covered California at a Glance
| Feature | Medi-Cal | Covered California |
|---|---|---|
| Type of coverage | California Medicaid program | Marketplace for private health insurance |
| Who may qualify? | People who meet applicable Medi-Cal eligibility rules | People shopping for individual or family health coverage who meet marketplace eligibility requirements |
| Monthly premium | Usually free or low cost for eligible members | Premium depends on plan, household, income, location, and available financial help |
| Income rules | Different limits apply depending on Medi-Cal category | Income affects eligibility for financial help and the amount of assistance |
| Health plans | Medi-Cal Managed Care plans vary by county | Private plans available through Covered California |
| When can you apply? | Year-round | Usually during Open Enrollment or after a qualifying life event |
| Where to apply | BenefitsCal, Covered California, county office, phone, mail, or in person | Covered California |
What Is Medi-Cal?
Medi-Cal is California's Medicaid program. It provides health coverage to eligible Californians based on income and other eligibility rules.
Medi-Cal covers a wide range of medically necessary services. Depending on eligibility and coverage, benefits can include:
- Doctor visits
- Hospital services
- Emergency care
- Prescription drugs
- Preventive services
- Mental health and substance use disorder services
- Pregnancy and maternity care
- Dental benefits
- Vision services
- Long-term services and supports for some members
What Is Covered California?
Covered California is California's official health insurance marketplace.
It allows eligible individuals and families to compare and purchase private health insurance plans. Depending on household income and other eligibility requirements, some consumers may qualify for financial assistance that lowers the cost of coverage.
Covered California plans are private health insurance policies rather than Medi-Cal coverage.
What Are the 2026 Medi-Cal Income Limits?
There is not one Medi-Cal income limit for everyone.
For many adults ages 19 through 64 who qualify under the MAGI Medi-Cal category, the income standard is generally up to 138% of the Federal Poverty Level (FPL).
For 2026, the approximate annual 138% FPL limits are:
| Household Size | 138% FPL Annual Income |
|---|---|
| 1 | $22,025 |
| 2 | $29,864 |
| 3 | $37,702 |
| 4 | $45,540 |
The 138% FPL rule does not apply to every Medi-Cal applicant. Different income rules may apply to children, pregnant individuals, people age 65 or older, people with disabilities, Medicare beneficiaries, long-term-care applicants, and other Medi-Cal categories.
Does Covered California Have an Income Limit?
Covered California itself is a marketplace for private health insurance, so people at many income levels may purchase coverage if they otherwise qualify.
Income is especially important when determining whether you qualify for financial help and how much assistance you may receive.
Financial-help rules can change from year to year. Do not rely on an old income chart when estimating Covered California assistance. Use Covered California's current Shop and Compare tool or official eligibility chart for the coverage year you are applying for.
What If Your Income Is Near the Medi-Cal Limit?
You do not need to decide on your own whether you belong in Medi-Cal or Covered California.
When you apply through Covered California, your information can be reviewed to determine whether you may qualify for Medi-Cal or for a Covered California health plan.
This is particularly helpful when your income is close to the Medi-Cal eligibility threshold.
Can Different Family Members Have Different Coverage?
Yes. A household does not always have to be enrolled in the same program.
For example, children may qualify for Medi-Cal under an income standard that is different from the standard that applies to their parents.
A parent may be enrolled in a Covered California plan while a child in the same household qualifies for Medi-Cal. This is sometimes called a mixed-program household.
Can You Have Medi-Cal and Covered California at the Same Time?
This question needs an important distinction.
A person who qualifies for certain full-scope Medi-Cal coverage generally cannot also receive Covered California premium tax credits for that same person.
However, different people within the same household can sometimes have different coverage, such as a child with Medi-Cal and a parent with a Covered California plan.
If you receive a notice saying you have become eligible for Medi-Cal while you already have Covered California coverage, review the effective dates carefully before canceling or changing any plan.
How Do You Apply for Medi-Cal?
Medi-Cal applications are accepted throughout the year.
You can apply:
- Online through BenefitsCal
- Online through Covered California
- By phone through your county Medi-Cal office
- By mail
- In person at your county office
BenefitsCal:
https://www.benefitscal.com/
How Do You Apply Through Covered California?
Covered California allows you to compare available health plans, estimate financial assistance, and submit an application.
The application may also identify household members who appear eligible for Medi-Cal.
Covered California:
https://www.coveredca.com/
When Can You Enroll?
Medi-Cal
You can apply for Medi-Cal at any time during the year.
Covered California
Covered California generally has an annual Open Enrollment period.
Outside Open Enrollment, you may still qualify for a Special Enrollment Period after certain life events, such as losing other health coverage, getting married, having a baby, or moving under qualifying circumstances.
What Happens If Your Income Changes?
Changes in income can affect which program you qualify for and how much financial help you receive.
For example:
- If your income increases, you may no longer qualify for Medi-Cal and may become eligible for a Covered California plan.
- If your income decreases, you may become eligible for Medi-Cal.
- If you already receive Covered California financial assistance, an income change may increase or decrease your subsidy.
Report income and household changes promptly. Do not simply stop paying for or cancel your existing coverage because you believe you qualify for another program. Confirm the new coverage and its effective date first to reduce the risk of a coverage gap.
Which Is Better: Medi-Cal or Covered California?
Neither program is automatically better for everyone. More importantly, you usually cannot simply choose Medi-Cal if you do not meet its eligibility requirements.
Medi-Cal may apply if:
- You meet the eligibility requirements for a Medi-Cal category.
- Your income falls within the applicable program limit.
- You qualify through another Medi-Cal eligibility pathway.
Covered California may apply if:
- You need individual or family private health insurance.
- You do not qualify for Medi-Cal.
- You meet Covered California enrollment requirements.
- You may qualify for financial assistance based on the rules for the coverage year.
Frequently Asked Questions
Is Medi-Cal the same as Covered California?
No. Medi-Cal is California's Medicaid program. Covered California is the state's marketplace for private health insurance.
Can I apply for Medi-Cal through Covered California?
Yes. DHCS lists Covered California as one of the official online ways to apply for Medi-Cal.
Can I apply for Medi-Cal through BenefitsCal?
Yes. BenefitsCal is also an official online application option for Medi-Cal through your county.
If I qualify for Medi-Cal, can I receive a Covered California premium subsidy instead?
Generally, a person who is eligible for qualifying full Medi-Cal coverage is not eligible to receive Covered California premium tax credits for that same person. Individual circumstances can differ, so review your eligibility notice carefully.
Can my child have Medi-Cal while I have Covered California?
Yes, that can happen. Medi-Cal income standards for children can be different from those for adults, so members of the same household may qualify for different programs.
Should I cancel my current plan as soon as I qualify for another program?
Do not cancel existing coverage until you confirm the new program's approval and effective date. This can help prevent an unintended gap in health insurance.
Key Takeaway
Covered California is the state's marketplace for private health insurance and financial assistance.
Your household income, household size, age, pregnancy status, disability status, Medicare status, immigration-related eligibility rules, and other factors can affect which program applies to you.
Official Sources & Resources
- DHCS – Apply for Medi-Cal
- Covered California – Medi-Cal
- Covered California – Federal Poverty Level and Financial Help
- Covered California – How to Apply
- BenefitsCal
California Benefits Guide is an independent informational website and is not affiliated with, endorsed by, or operated by the California Department of Health Care Services (DHCS), Medi-Cal, Covered California, BenefitsCal, any county agency, health plan, insurance company, or other government agency.
This article is provided for general educational and informational purposes only and does not constitute legal, tax, medical, insurance, or eligibility advice. Medi-Cal eligibility rules, income limits, Covered California financial assistance, enrollment periods, immigration-related rules, and health plan options may change. Always verify your individual eligibility and current program rules directly with DHCS, Covered California, BenefitsCal, your county Medi-Cal office, or the applicable health plan.